An Inside Look at MS Research

Tag Archives: ECTRIMS2016

Each year ECTRIMS ends with a bang as late-breaking research news is presented first thing in the morning. Presenters at the late-breaking news session deliver the newest key findings of pivotal studies and clinical trials. At the session, we heard about a new potential biomarker that can help evaluate the success of progressive MS trials, the effectiveness of available MS disease-modifying therapies in the real world, and topline results from clinical trials of emerging progressive MS and symptom management treatments. Read on for highlights from the ECTRIMS late-breaking news session.

While platform presentations tend to get all the glory and attention at scientific conferences, I like to think of poster presentations as the unsung heroes that cover an enormous breadth of topics and give researchers at all stages of their careers an opportunity to showcase their research. This year’s ECTRIMS conference saw a record-breaking 1,985 abstract submissions, the majority of which were poster presentations spanning topics as diverse as immune mechanisms and remyelination, symptom management approaches, imaging techniques, biomarker discovery, and findings from clinical trials, to name a few. In this post, I’d like to highlight just a few of the posters I came across that focused on how factors like diet, physical activity, mood and fatigue can play a role in the lives of people living with MS and allied diseases.

Ever since disease-modifying therapies emerged onto the scene in the mid-1990s, suppression of damaging inflammation and prevention of the entry of harmful immune cells into the central nervous system (CNS) has formed the backbone of MS treatment. In more recent years, the dialogue has shifted to the topic of remyelination – in other words, coercing the body’s innate repair system to rebuild the myelin damaged during MS. This topic continues to be an unmet need in MS and is receiving a lot of attention at this year’s ECTRIMS conference, where the leaders in remyelination research have converged to share their perspectives and latest findings on myelin repair.

This morning at ECTRIMS we heard from several researchers and clinicians about the use of imaging as a tool to predict disease outcomes in MS. Over the last few days we saw results from studies repeatedly demonstrating that imaging is a strong predictor of:

The development of MS in those who exhibit early signs

The development of disability (or worsening of disease)

Imaging has been heralded as the strongest predictor of disease outcomes in MS, and longer studies are not able to pinpoint the long term predictive nature of imaging measures.

Dr. Olga Ciccarelli from University College London presented an overview of the different imaging tools and patterns that can predict risk of developing confirmed MS among those with clinically isolated syndrome (CIS). She referenced studies showing that, after a 20 year follow up, those individuals with CIS who had an abnormal MRI (many lesions displayed on scan) had an 82% risk of developing MS, whereas those with a normal MRI had a 21% risk of MS.

She also noted that T2 lesions, which are seen via a specific MRI method that shows tissue damage and inflammation, are a strong prognostic factor, meaning they can predict disease, which was demonstrated in a paper published in 2015 in Brain by Dr. Mar Tintoré from Vall d’Hebron University Hospital in Barcelona, Spain.

Additional studies were presented showing that people with early signs of MS who also exhibited spinal cord lesions were more likely to develop MS. Dr. Ciccarelli published similar work showing that spinal cord lesions and spinal cord atrophy (tissue damage) can predict levels of disability after 5 years in patients with CIS. She is currently working on the longest follow-up study of patients with CIS (30 years), which will reveal the strength of imaging as a predictive tool for MS disease and add to our current knowledge around risk models for MS.

We also heard from Dr. Tintoré who has done significant work on monitoring CIS patients over the long term. She has been leading a large, real-world, prospectively acquired (acquiring data over time) CIS cohort that has enabled her to identify predictors of EDSS changes, treatment responses, and other disease outcomes. She presented data from her cohort study showing that, after 15 years of follow up, those with CIS who had more than 10 lesions observed on their first (baseline) MRI had an 85% risk of MS, compared to 19% for those who had no lesions on their first MRI. She found that a lower proportion of patients developed accumulation of disability after 10 and 15 years, and early treatment appeared to have prevented the buildup if disability.

Dr. Wallace Brownlee, also from University College London, presented his study on the prognostic strength of imaging in terms of predicting a secondary progressive disease course in those with CIS. He initially enrolled 178 patients with CIS, of which 164 were followed up for a total of 15 years. After the 15 year follow up period ended, 57% of patients had relapsing-remitting MS (RRMS), and 15% had secondary progressive MS (SPMS). He noted that those with CIS who had spinal cord and T1 brain lesions had a higher probability of developing SPMS, meaning those imaging markers are strong predictors of transition to SPMS.

As imaging techniques become more refined, and studies better designed and include larger numbers of people to infer more definitive conclusions, clinicians are becoming better equipped to foretell the outcome of one’s MS over the short and long term. This is especially important for those with the earliest signs of MS as deciding the most appropriate treatment course for those individuals can influence how their disease unfolds in the future

Stay turned for most updates from ECTRIMS, and follow me on Twitter where I will posting live from the sessions throughout the day!

How quickly time flies. A little over a year ago, the MS Society announced the recipients of the International Progressive MS Alliance planning awards, the first step in an unprecedented global effort designed to forge collaborations between people of all research backgrounds and scientific expertise around the world, who together have the capacity to speed up the development of treatments for progressive MS. Each of the 11 grant recipients developed proposals for larger-scale projects aimed at addressing the most complex scientific and healthcare challenges in progressive MS. The proposals were submitted for another round of reviews, after which three projects would be selected for €4.2 million (or $6 million) in funding.

Today at an ECTRIMS press conference, The Alliance announced the successful awardees of the €4.2 million Collaborative Network Award grants. The three selected multi-national research networks will tackle critical gaps facing progressive MS research, including the development of effective drugs for countering disease progression, the discovery of new biomarkers that can help researchers measure progression and the response to treatments, and the design of faster and smaller clinical trials that will cut down on the time needed to bring new therapies from the drawing board to people living with MS.

I’m happy to note that one the grant recipients is from Canada: Dr. Douglas Arnold from the Montreal Neurological Institute at McGill University. Additionally, several other Canadian researchers were among the collaborators listed for all three grants, including Dr. Jack Antel from McGill University and Dr. Alexandre Prat from the University of Montreal.

In May of this year ECTRIMS announced that a record breaking 1,985 abstracts were submitted for the Congress, representing a broad a range of topics such as neuroprotection, advance imaging techniques, multidisciplinary rehabilitation, cognitive treatments, comorbidities, and new directions in progressive MS research. Selected abstracts will be presented throughout the week at poster sessions (researchers showcase their data on posters and engage in discussions) and scientific sessions (presentations that are delivered to a larger audience). The conference also includes smaller workshops and presentation sessions for nurses, junior neurologists in training, and media.

ECTRIMS is a great platform for announcing breaking news in MS research and treatment, and provides an opportunity for researchers, clinicians and trainees to share the freshest data from their laboratories, in addition to networking, taking part in educational workshops, hearing about updates in other research areas, and collaborating with MS professionals across geographical regions, industries and expertise.

This year the research team will be delivering live updates throughout the week via Twitter (@Dr_KarenLee), Facebook (Multiple Sclerosis Society of Canada), and my blog. We are excited to hear about the latest advances, particularly in progressive MS where researchers are on the cusp of a new era of disease-modifying therapies and symptom-improving interventions.

Stay tuned for more updates and feel free to leave and questions or comments below!